PEER EDUCATION IN HIV/AIDS PREVENTION IN RIFT VALLEY TECHNICAL

INSTITUTE

PRESENTED BY:
JOY PURITY ATAYI

2023

DECLARATION
This research project report is my own work and it has not been submitted for any Certificate or
Diploma award in any other College

Joy Purity Atayi

Signature: ……………………………… DATE...................................................

 DEDICATION

This Research Project paper is dedicated to my family .

 ACKNOWLEDGEMENT

I would like to express my sincere gratitude to all those who made it possible for me to complete
this research project. I also want to express very special gratitude to my family who have been a
support in my line of success and above all I thank God Almighty for the care and guidance he
has given me to complete this project.
 TABLE OF CONTENTS
DECLARATION.................................................................................................................................ii
DEDICATION...................................................................................................................................iii
ACKNOWLEDGEMENT..................................................................................................................iv
ABSTRACT.........................................................................................................................................9
CHAPTER ONE..................................................................................................................................1
INTRODUCTION...............................................................................................................................1
1.1 Background of the Study..........................................................................................................1
1.2 Statement of the Problem.........................................................................................................1
1.3 Purpose of the Study................................................................................................................2
1.4 Objectives of the Study............................................................................................................2
1.5 Research Questions..................................................................................................................2
1.6 Significance of the Study.........................................................................................................3
1.7 Basic Assumptions of the Study..............................................................................................3
1.8 Limitations of the study...........................................................................................................3
1.9 Delimitations of the Study.......................................................................................................3
1.10. Conceptual framework................................................................................................................4
1.10 Definitions of Significant Terms used in the Study.................................................................5
CHAPTER TWO.................................................................................................................................6
LITERATURE REVIEW....................................................................................................................6
2.1 Introduction..............................................................................................................................6
2.2 Peer Education about HIV/ AIDS and Prevention of the Disease...........................................6
2.2.1 Peer Education, information Sources of Students and Prevention of HIV and AIDS.............6
2.2.2 Peer Education, HIV Education Curriculum and Prevention of HIV among Students in
Rift Valley Technical Institute.............................................................................................................8
2.3 Attitudes of Students and Prevention of HIV and AIDS.........................................................9
2.3.1 Attitudes of the Students towards Condom Use......................................................................9
2.3.2 Attitudes of the Students towards VCT Services...................................................................10
2.3.3 Attitudes of the Students towards PLHIV..............................................................................10
2.4 The Sexual Behavior of the Students and Prevention of HIV/AIDS.....................................11
2.4.1 Condom Use and Prevention of HIV/AIDS...........................................................................11
2.4.2 Uptake of VCT Services and the Prevention of HIV/AIDS..................................................11
CHAPTER THREE...........................................................................................................................13
RESEARCH METHODOLOGY......................................................................................................13
3.1 Introduction............................................................................................................................13
3.2 Research Design.....................................................................................................................13
3.3 Target Population...................................................................................................................13
3.4 Sample size and Sampling Procedures...................................................................................13
3.4.1 Sampling Techniques.............................................................................................................14
3.5 Research Instruments.............................................................................................................14
3.5.1 Validity of the Instrument......................................................................................................15
3.5.2 Pilot Testing...........................................................................................................................15
3.5.3 Reliability of the Instrument..................................................................................................16
3.6 Data Collection Procedure.....................................................................................................16
3.7 Data Analysis Techniques......................................................................................................17
3.8 Ethical Considerations...........................................................................................................18
CHAPTER FOUR..............................................................................................................................19
DATA ANALYSIS, PRESENTATION, INTERPRETATIONS, AND DISCUSSION..................19
4.1 Introduction............................................................................................................................19
4.2 Background Information of the Respondents........................................................................19
Table 5: Respondents’ demographic data..........................................................................................20
4.3 Education of Students about HIV/ AIDS and Prevention of the Disease..............................21
4.3.1 Education and Perceptions of Students on HIV and AIDS....................................................21
4.3.2 Source of Information about HIV and AIDS for Rift Valley Rift Valley institute student
22
Table 6: Sources of information about HIV/AIDS by the Students..................................................22
4.3.3 Modes of HIV Transmission in Rift Valley Technical Training Institute in Eldoret............23
Table 7: The Students’ Education on Modes of HIV transmission...................................................23
4.3.4 Strategies of HIV Prevention in Rift Valley Technical Training Institute in Eldoret............24
Table 8: HIV prevention strategies adopted by the Students in Rift Valley Technical institute.......25
4.3.5 Statements about HIV and AIDS...........................................................................................26
Table 9: Statements about HIV/ AIDS by the Students.....................................................................27
4.3.6 Cultural Practices and the Spread of HIV and AIDS in Rift Valley Technical Training
Institute in Eldoret.............................................................................................................................28
Table 10: The Students’s Education on cultural practices that enhance the spread of HIV/ AIDS. .29
4.4 Attitudes of the Students and their Participation in HIV Prevention on peer education.......30
4.4.1 Maintaining Secrecy about Family Member Infected with HIV...........................................30
Table 11: Level of secrecy by the Students about a family member’s infection with HIV...............30
4.4.2 Sharing a Desk with an Infected Classmate...........................................................................31
Table 12: Ability of the Students sharing a desk with an infected classmate....................................31
4.4.3 Encounter with STIs in Rift Valley Technical Training Institute in Eldoret.........................32
CHAPTER FIVE...............................................................................................................................33
SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS...........................33
5.1 Introduction............................................................................................................................33
5.2 Summary of Findings.............................................................................................................33
5.3 Conclusions............................................................................................................................33
5.4 Recommendations..................................................................................................................34
5.7 Areas for Further Research....................................................................................................35
REFERENCES..................................................................................................................................36
 LIST OF FIGURES

Figure 1: Conceptual framework..........................................................................................................4

 LIST OF TABLES

Table 1: Respondents’ demographic data...........................................................................................20

Table 2: Sources of information about HIV/AIDS by the Students...................................................22
Table 3: The Students’ Education on Modes of HIV transmission....................................................23
Table 4 HIV prevention strategies adopted by the Students in Rift Valley Technical institute.........25
Table 5: Statements about HIV/ AIDS by the Students.....................................................................27
Table 6: The Students’s Education on cultural practices that enhance the spread of HIV/ AIDS.....29
Table 7: Level of secrecy by the Students about a family member’s infection with HIV.................30
Table 8: Ability of the Students sharing a desk with an infected classmate......................................31
 LIST OF ABBREVIATIONS AND ACRONYMS
AIDS Acquired Deficiency Syndrome
HBM Health Behavior Model
HIV Human Immunodeficiency Virus
IDU Injecting Drug Users
KAIS Kenya AIDS Indicator Survey
HECP HIV Education Curriculum and Prevention
KNBS Kenya National Bureau of Statistics
MOH Ministry of Health
MOE Modes of Exposure
MOT Modes of Transmission
NACC National AIDS Control Council
NASCOP National AIDS and STIs Control Programme
PEP Post Exposure Prophylaxis
STI Sexually Transmitted Infections
VCT Voluntary Counseling and Testing
WHO World Health Organization
 ABSTRACT
Peer Education, attitudes and sexual behavior change towards HIV/AIDS remains a primary goal
of HIV prevention efforts. HIV and AIDS is one of the leading health problems in Kenya where
nearly 7.1% of the population had been infected by the disease in 2011. Uasin Gishu County is
having the highest (26%) prevalence of HIV. Thus, the purpose of this study was to assess Peer
Education in the prevention of HIV and AIDS in Rift Valley Technical Training Institute
The objective of the study was to assess how the Education on HIV/ AIDS, social conditions,
attitudes and the sexual behaviors of Rift Valley Rift Valley institute students influence their
participation in the prevention of HIV/ AIDS. The literature reviewed indicated that the
Education or information that high Rift Valley institute students have about HIV and AIDS is
not accurate since they still have misconceptions about the diseases. Students engage in sex from
the age of 11 years. This exposes them to the risk of acquiring HIV due to the inaccurate
Education that they have about prevention of the disease. Social conditions such as poverty also
prevent students from accessing VCTs and condoms, which they require to prevent the spread of
the disease. Negative attitudes towards people living with HIV and AIDS hinder prevention of
the disease by encouraging stigmatization. The study used a descriptive research design. The
target population was students in rural Rift Valley Technical Institute in Uasin Gishu County .
The data was collected from a sample of 371 students who were selected through a stratified
sampling technique. The data was collected using questionnaires with structured and
unstructured questions. Data analysis was conducted through descriptive statistics. The quality of
information about the disease among students should be improved to prevent the spread of the
disease. Students’ sexual behaviors and social conditions also expose them to the risk of
acquiring HIV/ AIDS. Thus, students should be encouraged to use condoms and refrain from
risky leisure activities such as drug abuse. The government in collaboration with the community
should address the stigma associated with HIV and AIDS to enhance its prevention.
 CHAPTER ONE

INTRODUCTION
1.1 Background of the Study

HIV and AIDS has in the past decades had devastating effects on the Students population,
especially, institute going students by causing deaths and stigmatization. Prevention of HIV/ AIDS
is critical for creating a healthy and productive population. According to WHO (2014), 95% of the
world population should have accurate Education about HIV and AIDS to prevent new infections.
However, in low and middle-income countries only 24% and 36% of young women and men
respectively have accurate Education about the disease. Lack of adequate Education prevents
individuals from taking preventive measures such as using condoms to avoid acquiring HIV and
AIDS.

According to (Murtala, 2009), safe sexual behaviors should be adopted to prevent the spread of
HIV/ AIDS. This includes avoiding unprotected sex, anal sex, and having multiple sexual partners.
Risky sexual behavior is still an obstacle to prevention of HIV/ AIDS since only 51% of individuals

aged 15-49 years use condoms in Sub-Sahara Africa, Middle East, and Latin America (UNAIDS
2014). Globally, risky behaviors such as anal sex, oral sex, and having multiple sex partners are still
common in most countries.

1.2 Statement of the Problem

HIV/ AIDS remain one of the major health challenges that Kenya is trying to deal with. Uasin
Gishu County is one of the districts with the highest HIV prevalence in Kenya. The infection rate in
the district is 26.3%, which is almost double the prevalence level in Rift Valley institute. About
70% of 15-19 years olds are sexually active and the first sexual intercourse occurs before the age of
15 years among the girls (Capacity Building International, 2009). The fact that HIV and AIDs is
mainly transmitted through sexual intercourse is well documented. In this regard, majority of the
Students in institute are at risk of being infected with HIV/ AIDS since they are sexually active.

At least 95% of the Students should have accurate Education about HIV and AIDS to prevent the
spread of the disease. In Kenya, the government has embarked on improving the Education of the
Students by introducing HIV/ AIDS education programmes in institutes. This has increased the
general awareness about HIV and AIDS in Rift Valley Technical Training Instittute in Eldoret .
However, the information that the Students have is not accurate since they still hold myths and
misconceptions about the disease. Lack of adequate and accurate Education prevents the Students
from taking preventive measures such as using condoms to avoid acquiring or spreading HIV/
AIDS.

Pending the discovery of an effective vaccine, therapy, or curative treatment, reduction of risk-
taking behavior is the only way through which the spread of HIV/AIDS pandemic can be arrested.
In particular, the spread of the disease in Rift Valley Technical Training Institute in Eldoret in
institute can be prevented if they avoid risky behaviors such as having unprotected sex. Access to
adequate and accurate Education about HIV/ AIDS can also enhance prevention. The Students are
likely to participate in the prevention of HIV/ AIDS if they have a positive attitude towards the
disease. It is against this background that this study sought to establish how the Education,
attitudes, social conditions, and sexual behaviors of the Students in Uasin Gishu County determine
their participation in the prevention of HIV/ AIDs.

1.3 Purpose of the Study

The purpose of this study was to assess the Peer Education in the prevention of HIV and AIDS in Rift
Valley Technical Training Institute

1.4 Objectives of the Study

The study was guided by the following objectives
1. To assess the level at which the peer Education of Students on HIV/ AIDS determine their
participation in the prevention of HIV and AIDS in Uasin Gishu County
2. To establish the extent to which the attitudes of Students determine their participation in
the prevention of HIV and AIDS in Uasin Gishu County
3. To examine how the sexual behavior of Students determine their participation in the prevention
of HIV and AIDS in Uasin Gishu County among Studentss

1.5 Research Questions

The research answered the following questions:

1. What is the level of Education of Students on HIV/ AIDS that determines their participation in
the prevention of HIV and AIDS in Rift Valley Technical Institute?
2. To what extent does the attitude of the Students determine their participation in the prevention
of HIV and AIDS in Rift Valley Technical Institute?
3. How does the sexual behavior of the Students determine their participation in the prevention
of HIV and AIDS in Rift Valley Technical Institute among Studentss?
1.6 Significance of the Study
The high prevalence of HIV and AIDS in Uasin Gishu County , estimated at 26.3%, creates a need
for intense prevention efforts in the District and other regions with comparable infection rates
(Kenya National Bureau of Statistics, 2010). National surveys are usually very expensive to carry
out. Consequently, the lowest level that data can be collected and analyzed is up to the regional
level (Capacity Building International, 2009). This means that in Kenya data can only be analyzed
up to the provincial level. Therefore, we hope that this study provided valuable insights that may
guide the target population in the process of preventing HIV and AIDS. Institutes have been a hard
to reach population due to the strict policy guidelines issued by the Ministry of Education.
Abstinence is the only prevention measure that can be taught in institutes, despite the fact that
majority of the population becomes sexually active by the age of 18 years. Thus, the findings of this
study, hopefully, may help the government through the ministry of education to adjust its policy
concerning HIV and AIDS education in institutes. Finally, studies that target the student population
are scanty, and the existing ones are inconclusive. Thus, this study contributed to the process of
designing policies and programs that are geared towards the prevention of HIV and AIDS.

1.7 Basic Assumptions of the Study

The study was based on the assumption that students enrolled in Rift Valley Technical Institute in
Uasin Gishu County were purely residents of the rural set up. This assumption is based on the fact
that the targeted institutes were located in rural areas in the County.

1.8 Limitations of the study

The main limitation of the study was that some respondents were reluctant to provide information
about their sexual behavior. In this regard, the study used anonymous questionnaires to encourage
the respondents to provide all the required information.

1.9 Delimitations of the Study

The study focused on the determinants of Students participation in prevention HIV and AIDS
prevention in Uasin Gishu County through peer Education. It was conducted using a survey
research design and a sample of 371 participants selected from the Rift Valley Technical Institute in
Uasin Gishu County was chosen because it has the highest prevalence rate in the country. In this
case, it was necessary to pay special attention to Uasin Gishu County to understand the
determinants of Students participation in the prevention of the disease in the district. Rift Valley
Rift Valley institute students were chosen as the target group because of the ease of accessing
them within a short time.
 1.10. Conceptual framework

Figure 1: Conceptual framework

Moderating Variable
Parents/ Teachers
discussion with the youth.
Peer education
Independent Variables
Knowledge of Youth on HIV and AIDS
Information Sources HIV Curriculum
Involvement of teachers and healthcare
workers Presentation of HIV and AIDS
Knowledge

Attitudes of Youth on HIV and AIDS

Dependent Variable
Age
Information on HIV and AIDS Stigma
associated with HIV and AIDS
Myths and misconceptions on HIV and Youth participation in the
AIDS prevention of HIV and AIDS
Reduced HIV incidence Delayed
sexual debut Reduced HIV and
AIDS Stigma and discrimination
Sexual behavior of youth and prevention
of HIV
Sexual debut Experience
School type (day/boarding/mixed) Socio-
economic status, religion

Social conditions and prevention of HIV

among the youth

Unequal gender norms Sexual violence

Traditional cultural practices HIV related
stigma
1.10 Definitions of Significant Terms used in the Study

Education of Students: Is defined as a justified true belief. For one to have Education, three
conditions must be fulfilled namely, the belief condition, the truth condition and the
grounds/ justification condition.
Attitude of Students: Can be defined as learned, relatively enduring dispositions to respond in a
consistently favorable or unfavorable ways to certain people, groups, ideas, or
situations. They may change and predict behavior. Therefore, attitude includes the
affect (psychological arousal), behavior, and cognition (thoughts).
Experience of Students: is defined as the content of direct observation or participation in an event.
Both psychological and emotional properties are integrated into this ongoing
personal-environment to give experience meaning and value and to enhance its
quality. For it to occur there has to be a physical presence, which consists of three
things: perceptual, intentional, and cognitive components.

Students: institute going person(s) aged between 14 and 21 years

Students Participation: Refers to the Students taking an active role in the prevention of HIV.

Prevention of HIV: Refers to ensuring that there is controlled HIV incidence among the institute
Students
Determinants of Students Participation: Factors that would influence the decision by the Students
in taking active role in the prevention of HIV
Social Conditions: Refers to factors that would make the Students vulnerable to HIV infection.
 CHAPTER TWO

LITERATURE REVIEW
2.1 Introduction

This chapter discusses the literature related to the determinants of Students participation in the
prevention of HIV and AIDS. It particularly focuses on the Education about HIV and AIDS in Rift
Valley Technical Training Institute in Eldoret ; attitudes of Students towards prevention of HIV and
AIDS; the sexual behavior of the Students and how it affects their participation in prevention of
HIV and AIDS; and how the social conditions of the Students affect their participation in
prevention of HIV/ AIDS.

2.2 Peer Education about HIV/ AIDS and Prevention of the Disease
AIDS is the leading cause of death among adolescents in Africa and the second highest globally
with 2.1 million adolescents living with HIV in 2013 globally. A greater percentage of this number
(83%) resides in sub-Saharan Africa with 250,000 new infections in 2013. There were 9720
adolescents and young people who died of AIDS in Kenya in 2013. (UNAIDS, 2014). The
Students are the most vulnerable since this is the stage at which they are curious and want test
things. Education and awareness would therefore be very important at this stage (WHO, 2004).

Education can be defined as a justified true belief. For it to occur three conditions must be fulfilled
namely, belief, truth, and grounds condition. Belief is the psychological state of mind or conviction.
Truth is the conviction that something is true, while the grounds condition refers to justification. It
is only when these three conditions are fulfilled that it can be said that Education has taken place
(Schelfer, 1965). The following will be discussed under this theme; Education and information
sources, and HIV curriculum in institutes and the prevention of HIV and AIDS.

2.2.1 Peer Education, information Sources of Students and Prevention of HIV and AIDS
Education of HIV and AIDS is essential for making behavioral choices that reduce the threat of
acquiring and transmitting the infection (NASCOP, 2009). In the last 10 years, educational

campaigns in Kenya have focused on disseminating information about the disease in terms of its
acquisition and prevention. According to Kenya National Bureau of Statistics (2010), about 99% of
Kenyans had heard about HIV and AIDS by 2010. 98.7% of adolescents who are the in institute had
Education about HIV and AIDS. There was a marginal difference in terms of the Education at the
rural and urban areas, standing at 99 percent and 99.5 percent respectively. However, the results
show that the Education of all key HIV prevention methods was lower among women and men
aged 15-19 years than among people aged 20 years and above. Despite the high Education on HIV
and AIDS, the prevalence in Nyanza is still very high.

In a study by Ndegwa (2002), 100% of both teachers and students in Nairobi were found to be
aware of HIV and AIDS. Majority of the students know the symptoms of HIV and AIDS and have
seen or even taken care of AIDS patients. On the other hand, only 50% of the students had
Education of preventive measures for HIV and AIDs. The study further revealed that teachers were
involved in the activities geared towards HIV prevention like counseling, teaching in class and in
general discussions with students. This means that if the teachers were well equipped with
information on HIV and AIDS, they would play an important role in the prevention of the disease
among students. Nonetheless, only 12.9% of teachers often teach about HIV/AIDS (Ndegwa,
2002). This implies that teachers are not well empowered as disseminators of the information about
HIV/AIDS prevention methods to students.

In a study on the Education of HIV and AIDS among Rift Valley Rift Valley institute students in
Calabar, Nigeria, Oyo-Ita, Ikpeme, Etokidem, Offor, Okokon and Etuk (2005) found that only
68.8 percent of the adolescents knew that HIV and AIDS is caused by a virus. 31.2 percent of the
adolescents did not know the etiological agents of HIV and AIDS, stating that it is caused by
bacteria or worms or did not know at all. The majority (90%) knew that HIV/AIDS is transmitted
through sexual intercourse. Only 13.4 percent of the adolescents knew that HIV carriers
might look normal.

Majority (89.5%) did not know the features of AIDS. Only 48.4 percent of the adolescents knew
that avoidance of sex, keeping one sexual partner, use of condom, and screening of blood
transfusion before use could prevent HIV transmission. Abstinence from sex was the common
mode of preventing HIV and AIDS among the adolescents. The main sources of information on
HIV and AIDS for the adolescents in this region included television (53.3%); radio (43.8%); health
talks and clinics (36.9%); and newspapers and magazines (35%). Only 2.2% of the adolescents
obtained information on HIV/AIDs from their parents. Therefore, the study concluded that although
the awareness on HIV and AIDS was high among the institute adolescents, parents, teachers, and
health workers should be more involved in educating the Students on this dreaded disease.
2.2.2 Peer Education, HIV Education Curriculum and Prevention of HIV among Students in
Rift Valley Technical Institute
The government of Kenya introduced an integrated HIV and AIDS education in the year 2000
(Kenya Institute of Education, 2000). The objectives of the program include the acquisition of
Education and the necessary skills about HIV/AIDS and other sexually transmitted diseases;
development of life skills that will lead to an AIDS and sexually transmitted diseases free life; to
identify sources of information on HIV and related issues; and making decisions about personal and
social behavior in order to reduce the risk of HIV and other sexually transmitted infections. Hussein
(2005), in his study of socio-economic and cultural factors in the transmission of HIV and AIDS
among the institute and college going Students in Garisa District refutes the claim that there is high
Education about the disease among learners. He observed that many young people were unaware
of what constituted risky sexual behavior that could expose them to HIV infection. The few learners
who had Education about the disease believed that they were invulnerable (Hussein, 2005). A
similar view was advanced by Johnston (2000) who noted that even though Education about the
nature and transmission of the disease is over 90% among Kenyan Students, the perceptions about
the chances of contracting the virus are very poor. Generally, young people already know
something about sex and HIV/AIDS. However, the information could be inadequate and wrong or
incomplete.

According to Ongunya et al (2009), the content of the HIV/AIDS education program has not been
reviewed since its introduction in 2000 in response to emerging issues concerning the disease. For
instance, materials on VCT services are clearly missing from the content of the program.
Additionally, the program lacks practical orientation and only concentrates on delivering superficial
Education because it is taught as a contemporary theme in secondary education curriculum. This
finding suggests that a gap exists between the objectives and the actual HIV and AIDS education
program delivery and behavior change in institutes. This disconnect may be emanating from the
presentation of the Education itself or lack of proper focus. The Students in institute are exposed to
HIV and AIDS education Education in the form of contemporary themes, which they expect to
memorize during examinations and not to influence them to change their behavior.

2.3 Attitudes of Students and Prevention of HIV and AIDS

Attitudes towards VCT, attitudes towards condoms and condom and attitudes towards persons
living with HIV and AIDS will be discussed under this theme.Eiser (1988) describes attitude as a
form of experience that (a) refers to specific objects, events, people or issues, and (b) is primarily
evaluative. He further says that people express their attitudes by describing the objects of their
experience in evaluative terms. Additionally, people do not typically treat their attitudes as just a
matter of opinion, but regards them as truth at least until someone can introduce new facts or
arguments to change their minds (Eiser, 1988). Fishben and Ajzen (1975) describe attitudes as
learned, relatively enduring dispositions to respond in a consistently favorable or unfavorable ways
to certain people, groups, ideas, or situations. This definition implies that attitudes are learned, they
may change, and they may predict behavior (Fishbein & Azjen, 1975).

2.3.1 Attitudes of the Students towards Condom Use

Ochieng et al (2011), notes that wider delivery of effective behavior change strategies is central to
reversing the global HIV epidemic. In her study of HIV prevalence and condom use among Rift
Valley Rift Valley institute students in Kisumu district in Rift Valley institute, she finds that
more than half of the students reported early onset of sexual activity with the majority indicating
that they initiated sexual intercourse between the ages of 11-15 years.

She further states that condoms are an integral part of HIV prevention and care programs. Thus,
their promotion must be accelerated. Latex condoms are effective barriers to HIV and other STIs
when used in every act of intercourse. This protection is most evident in HIV discordant couples.
Condom Education and attitude ranked low in the study population. For example, there was a
negative attitude towards the protective role of condoms in preventing HIV transmission. Even
though the majority of students had seen a condom and believed that they were effective in
protecting against pregnancy, only 22.9% thought that condoms were effective in protecting against
HIV/AIDS. Similar results have been reported by Toroitich (2004) who found that 43.8% of
students believe that condoms could slip off the man and disappear inside the woman’s body.
2.3.2 Attitudes of the Students towards VCT Services
Voluntary counseling and testing for HIV has become a major component of the expanded
responses to the HIV/AIDS pandemic. Early testing for HIV/AIDS offers many benefits for young
people, but in many countries, it is still rare. In Kenya, existing counseling and testing centers are
situated mainly in urban and semi-urban areas. The increasing demand for VCT services can be
attributed to several factors. First, individuals have a right to know their sero-status in order to
protect themselves and others from infection. Second, early detection may help individuals to
access sources of support and variety of treatments for opportunistic infections associated with HIV
and AIDS (Kiragu, 2001; Population Council and UNFPA, 2002).VCT can result in a reduction in
risk taking tendencies and promote behavior change.

The stigma associated with HIV/AIDS may be a key factor that reduces the uptake of VCT services
among the students. The challenge now is to link awareness creation with service delivery. Most
VCT services are located in public health facilities. Additionally, there is a general lack of
confidence in reproductive health services provided in public health facilities. This has clearly been
extended to VCT services. Plans to roll out more VCT centers across the country must consider
this. VCT services in most areas are currently located in the district hospitals. Most of the Students
recommend that VCT centers be located in private places such as Students centers. It has also
been widely suggested that the centers be located in areas that the Studentss frequent such as
churches, villages, hospitals, institutes and market places.

2.3.3 Attitudes of the Students towards PLHIV

Stigma and discrimination in a population can adversely affect both people’s willingness to be
tested and their adherence to antiretroviral therapy. Reduction of stigma and discrimination in a
population is, thus, an important indicator of the success of programmes targeting HIV and AIDS
prevention and control (KNBS 2010). In a survey by the KNBS, respondents who had heard of HIV
and AIDS were asked if they would be willing to take care of a family member who is suffering
from AIDS in their own households; if they would be willing to buy fresh vegetables from a market
vendor who had the AIDS virus; if they thought a female teacher who had the AIDS Virus, but not
sick should be allowed to continue teaching; and if they would want to keep a family member’s
HIV status secret. Among the institute going Students, 27.1 percent expressed accepting attitudes
on all the four indicators. Urban women are more likely than their rural counterparts to have
accepting attitudes on all the four measures towards people affected by HIV and AIDS.
Kasonde (1996) established that 95 percent of the Students feel that HIV and AIDS is on the
increase because the people who are HIV positive are busy spreading the HIV virus by having
multiple partners. Ndegwa et al (2002), on the other hand, established that most people associate
HIV and AIDS with loose morals.

2.4 The Sexual Behavior of the Students and Prevention of HIV/AIDS

Under this theme, the following will be discussed as sub themes; condom use and the prevention of
in Rift Valley Technical Training Institute in Eldoret and the uptake of Voluntary Counseling and
Testing services (VCT) in Rift Valley Technical Training Institute in Eldoret .

2.4.1 Condom Use and Prevention of HIV/AIDS

Kabiru (2005) in her study of sexual relationships among high Rift Valley institute students in
Kenya found that approximately 50% of males and 11% of females have had sexual intercourse at
least once in their lifetime. For both males and females, the proportion of sexually experienced
respondents increased with increasing grade level. A higher percentage of students in provincial
institutes than in national institutes reported that they were sexually experienced. Regarding
institute type, the highest proportion of sexually experienced female respondents was among those
attending mixed day and single gender boarding institutes, while in males it was among those
attending mixed day and boarding institutes.

Kabiru (2005) also noted some of the risky behaviors that students engage in. These included going
to a disco clubs, going to Students parties, smoking cigarettes, drinking beer, drinking illicit brews,
smoking marijuana, and using other drugs. Some of the drugs reported by students included
cocaine, heroin, mandrax, khat, and kuber. 23% of females and 13% of males stated that they had
never engaged in any of these activities, while one female and six males stated that they often
engaged in all the seven risky behaviors. The results indicated that close to 50% of females and
60% of males engage in at least one of the behaviors sometimes or often.

2.4.2 Uptake of VCT Services and the Prevention of HIV/AIDS

VCT services mainly target asymptomatic individuals. By informing clients of their HIV sero-status
and creating personalized HIV prevention plans, VCT centers can provide the support necessary to
change risky sexual behaviors and prevent the transmission of HIV (Voluntary HIV-Counseling &
Testing Efficacy Study Group, 2000). Since their implementation, VCT programs have
demonstrated their ability to promote safe sexual behaviors, as well as, to provide care and support
services among adults (Matovu et al, 2005). In spite of this progress, up to 80% of Kenyans aged 15
to 54 still do not know their HIV status (NASCOP, 2005).
Perception of the VCT process itself is instrumental in eventual uptake of VCT services. Factors
that influence uptake of VCT services may be based on past experience with being tested for HIV,
second-hand information about the testing process, the experiences of acquaintances and friends, as
well as, other factors that increase or reduce the perceived difficulty of attending a VCT clinic
(Kakoko, Astrom, Lugoe, & Lie, 2006).
 CHAPTER THREE

RESEARCH METHODOLOGY
3.1 Introduction

This chapter describes the methodology that was used to conduct the study. These include the
research design, target population, sample size, sample selection, research instruments, data
collection procedures, data analysis techniques, and ethical issues in research.

3.2 Research Design

This study adopted descriptive survey research design. The study is concerned with the
determinants of Students participation in the prevention of HIV and AIDS. Concisely, it assessed
the relationship between Education, attitudes, sexual behavior, and social conditions of the
Students in the prevention of new HIV infections. These issues can be best investigated through the
descriptive survey research design. This design involves studying the populations by selecting
samples to discover and to analyze occurrences in order to provide quantitative descriptions of the
aspects of the problem (Mugenda & Mugenda, 2003). The design was suitable because it enabled
the researcher to collect data rapidly and to understand the population from just a portion of it.
Standardization was used to ensure that similar data is collected from the target group and
interpreted comparatively (Mugenda & Mugenda, 2003). The weakness of the design is that an
inflexible data collection tool had to be used. Concisely, the data collection tool remained
unchanged throughout the study. However, this weakness is insignificant compared to the
contributions that the study has made.

3.3 Target Population

The study was conducted in Rift Valley Technical training Institute. The County was identified
because it is one of the regions among with the infection rates in the Province and in the Country
(Ministry of Planning, 2008). The target population was the Rift Valley Technical training Institute
student. Hence, the target population consisted of 10311 students in total.

3.4 Sample size and Sampling Procedures

This section will describe how the sample size was determined; sampling techniques; and the
selection of the respondents for the study.
3.4.1 Sampling Techniques
This section explains the sampling techniques that were used to obtain the samples for the study.
This study employed purposive sampling, stratified sampling, and simple random sampling
techniques.

In purposive sampling, the researcher decides whom to include in the sample. In this case, the
researcher was interested only in day Rift Valley Technical Institute in Uasin Gishu County
District. This is because the researcher was interested in students residing in the rural areas of the
District. The assumption was that the students in the rural day Rift Valley Technical Institute are
residents of rural areas. Since the District does not have one-sex day Rift Valley Technical Institute,
only mixed day Rift Valley Technical Institute were included, in this case 34 institutes.

Simple random sampling is a technique that selects a sample without bias from the accessible
population in order to select a representative sample. It ensures that each member of the target
population has an equal and independent chance of being included in the sample (Osoo&Onen,
2004).

The study also employed stratified sampling. This technique identifies sub-groups in the population
and their proportion. Respondents are then selected from each sub-group to form a sample. The
purpose of this technique was to group the population into homogeneous subsets i.e. boys and girls.
The proportion of boys to girls was about 2:1 i.e. 6869 divided by 3712. This was to ensure
equitable representation of the population in the sample.

3.5 Research Instruments

Data for this study was obtained from primary and secondary sources, as well as, oral interviews
and intensive literature search. The primary data was collected using a set of questionnaires. The
questionnaires were designed based on the nature of the data that was to be collected, available
time, literature reviewed from related studies, as well as, the objectives of the study. The researcher
was mainly concerned with the Education, attitudes, sexual behavior, and social conditions
regarding the prevention of HIV infection. The best methods for collecting this data are
questionnaires and interviews (Touliatos & Compton, 1988).

The researcher used a semi-structured questionnaire. This means that the tool had both open and
close-ended questions. This enabled the researcher to balance between quantitative and qualitative
of data, as well as, to collect more information. This balance was useful in the explanation of the
area of study.

The questionnaire was divided into five areas: part A, which had demographic profile with
questions about age, education level, religion and sex; part B, which had questions pertaining to

HIV and AIDS Education; part C, which had questions pertaining to attitudes on HIV and AIDS;
part D, which had questions pertaining to HIV and AIDS sexual behavior; and lastly part E, which
focused on recommendations for enhancing HIV and AIDS Programs as well as the social
conditions.

Questionnaires were used since this study was mainly concerned with variables that cannot be
directly observed such as Education, attitudes, experience, and expectations of the respondents.
Such information is best collected through questionnaires. The sample size was also quite large
(371) and given the time constraints, the questionnaire was the ideal tool for collecting data. The
target population was also unlikely to have difficulties in responding to the questionnaires.

3.5.1 Validity of the Instrument

Validity is the accuracy and meaningfulness of inferences, which are based on the research results.
It is the degree to which the results obtained from the analysis of data accurately represent the
phenomenon under study (Mugenda & Mugenda, 2003). Therefore, to ensure content validity, the
tool was given to professionals/experts in the HIV and AIDS field to assess the concept that it was
trying to measure and to determine whether the questionnaire items accurately represented the topic
of the study. The piloting of the instrument also enabled the researcher to improve on the content
validity of the tool.

3.5.2 Pilot Testing

Pilot testing can be described as a small-scale trial run of a particular component, in this case, the
questionnaire. It involves the use of a small number of respondents to test the appropriateness of the
questions and their comprehension. The pretest sample is usually between 1% and 10%. Therefore,
the main purpose of pilot testing is to identify potential problems with the methods, logistics, and
the questionnaire (Mugenda & Mugenda, 2003).

Rift Valley Technical Institute were selected within Eldoret town and the researcher requested the
institute administrators to provide the list of students per gender. Ten percent of the sample size i.e.
10% of 371, which is approximately 37 students, was selected based on the ration of boys to girls.
Six research assistants who had been trained on interviewing skills, research ethical considerations,
and on the questionnaire itself interviewed the students. After the first set of interviews, the
questionnaires were studied in order to iron out difficulties and or, challenges before the next set of
interviews.

The pilot test data was used to determine the reaction of respondents to the different aspects of the
study, which included timing, acceptability of the questions, and willingness of the respondents to
cooperate. It was also helpful in discovering errors in the instrument. This included the reliability of
the instrument, time taken/needed to conduct the interviews and if there was, need to adjust the tool.
It also helped in assessing the sampling procedures, as well as, the training of the research
assistants.

3.5.3 Reliability of the Instrument

Reliability is a measure of the degree to which a research instrument yields consistent results or
data after repeated trials (Mugenda & Mugenda, 2003). It is influenced by random errors. As
random errors increase, reliability decreases and vice versa.

In order to ensure reliability of the instrument, the researcher considered the consistency with which
the answers were generated. This was established at the piloting stage where the ease of interpreting
and answering the questions was determined. The inconsistencies that were noted in interpreting the
questions were addressed by rephrasing the questions and instructions to make them clearer to the
respondents. This helped to improve the consistency of the answers provided by the respondents.
Randomization was also used in the selection of participants from the population to avoid bias by
improving the representativeness of the sample.

3.6 Data Collection Procedure

The data collection process began with a formal acquisition of a permit from the National Council
of Science and Technology to conduct the research. A letter of introduction for the researcher was
also obtained from The Rift Valley Technical Training Institute’s campus administrator. These
documents were presented to the Ministry of Education in Uasin Gishu County in order to obtain
clearance and support during the data collection process.

The second step in the data collection process involved training six research assistants for two days
so that they could understand the study’s objectives and to master the research tool, as well as, to
understand the ethical considerations and to plan approaches to data collection. The research
assistants were recruited from the district where the study was conducted. The third step involved
conducting a pilot test to verify the validity of the questionnaires. The results of the pilot test were
used to correct the questionnaires to enhance the quality of data collected.

The fourth step was fieldwork in which quantitative and qualitative data . The data was collected by
six trained research assistants under the supervision of the researcher using questionnaires that had
both closed and open-ended questions. The respondents were expected to respond to the closed
ended questions by making choice(s) to the list that was provided in the questionnaires. On the
other hand, the respondents were expected to give personal opinion(s) for the open-ended questions
in the questionnaires. The research assistants administered questionnaires through interviews to
students in one institute at a time. The help of research assistants was required because the
researcher could not administer the questionnaires to all the 371 respondents by himself due to time
constraint.

3.7 Data Analysis Techniques

Quantitative analysis technique and inferential were used to analyze the data. Descriptive statistics,
which is part of quantitative analysis technique, summarized data on the objectives of the study to
enable the researcher to describe the measurements using a few statistics. On the other hand,
inferential analysis was used to draw conclusions concerning the relationships and differences
found in the research results.

Descriptive statistics provided simple summaries about the sample and measures. Together with
simple graphical analysis, they formed the basis of quantitative analysis of data. Inferential analysis,
on the other hand, enabled the researcher to use sample statistics to draw conclusions about the
population, i.e. students from rural Rift Valley Technical Institute in Uasin Gishu County .
Frequency tables cross tabulations and correlations were generated and formed the backdrop of
research’s findings and recommendations.

The researcher grouped data from open-ended items and interviews under broad themes and
converted them into frequency counts. Data from the closed ended questions were assigned
numerical values to facilitate analysis. This was then keyed into SPSS spreadsheets for analysis.
The data was analyzed at a level of significance of 5%. This value was chosen because the sample
size was adopted from figures calculated on the basis 0.95 level of significance.
3.8 Ethical Considerations
The main ethical issues in this study included informed consenting, privacy, confidentiality, and
anonymity.
Informed Consent- it implies informing the respondents about the procedures of the study in
which they will be participating. The respondents were provided with information on the purpose of
the research, expected duration of participation, the procedure to be followed, unforeseen

discomforts, as well as, the extent of privacy and confidentiality. Once this was done, the
respondents were expected to voluntarily participate in the exercise.

Privacy and confidentiality- To ensure privacy and confidentiality, the respondents were
interviewed one at a time in a private room that was provided by the institute administration.
Anonymity- for anonymity purposes, the researcher did not ask for the respondents’ names in the
questionnaires. Thus, numbers were used to represent the respondents.
 CHAPTER FOUR

DATA ANALYSIS, PRESENTATION, INTERPRETATIONS, AND DISCUSSION

4.1 Introduction
The results of data analysis will be presented in this section. The results cover the Education about
HIV/AIDS among Rift Valley Rift Valley institute students ; attitudes of Rift Valley Rift Valley
institute students towards prevention of HIV/ AIDS; the sexual behavior of Rift Valley institute
students and how it affects their participation in prevention of HIV/ AIDS; and how the social
conditions of Rift Valley Rift Valley institute students affect their participation in prevention of
HIV/ AIDS.

4.2 Background Information of the Respondents

Background analysis of respondents’ characteristics is important as it depicts a concise
understanding of HIV and AIDS issues in Rift valley Technical training Insitute. Some
demographic data captured oscillates around distribution of respondents by age group, religion,
gender/sex and class/form. These parameters were deemed important in the survey because data on
HIV and AIDS are largely influenced by the demographics of the Students and therefore the
recommendations proposed should be formulated around the demographic data captured. The
respondents were asked to provide their background information, which included their demographic
data such as age, gender, and religion. Table 4 shows that majority (61.2%) of the respondents were
male students. 149 students or 52.3% of the sample were Protestants, whereas the rest belonged to
other denominations such as Catholic and the Orthodox Church. 230 students or 62% of the sample
were in the age group of 16 to 18 years. However, 13 students did not indicate their age. Form two
and three had the highest number of respondents, which stood at 114 (30.7%) and 106 (28.6%)
respectively.
 Table 1: Respondents’ demographic data

Demographic characteristic Frequency (n) Percentage (%)

Sex/ gender Male 227 61.2
Female 144 38.8

Total 371 100

Religion/ denomination Catholic 149 40.2
Protestant 194 52.3
Muslim 0 0
Orthodox 5 1.3
Traditionalist 22 5.9
Pagan 1 0.3
Total 371 100
Age group 13-15 90 24.2
16-18 230 62
19-21 38 10.2
Not indicated 13 3.5

Total 371 100

Class/ Form Form one 67 18.1
Form two 114 30.7
Form three 106 28.6
Form four 84 22.6

Total 371 100

Gender distribution determines Students participation in prevention of HIV and AIDS due to the
socio- economic and biological vulnerability of females as opposed to males. Gender bias is deeply
rooted in cultural and traditional values, which discriminate against the female gender. Gender
inequality is a salient socio-cultural issue that puts women at a lower bargaining power in the
decision-making process pertaining to HIV and AIDS. Respondents were therefore asked to state
their gender and table 4 states the gender distribution within the district.
Religious affiliation is an important characteristic as it has significant influence on the determinants
of Students participation in prevention of HIV and AIDS. Table 4 captures the data on religious
affiliation. From the table, the Protestants constituted the majority at 52.3 percent followed by
Catholics at 40.2 percent, traditionalists at 5.9 percent, orthodox at 1.3 percent, pagan at 0.3 percent
and no Muslims. HIV and AIDS programs should therefore incorporate religious leaders and
gatekeepers and exploit the existing good will to disseminate pertinent information on HIV and
AIDS. Catholics for example have a strong stance on condom use and this may call for other means
of prevention other than the condom.

Age distribution is important in the study as different age groups have unique characteristics
pertaining to HIV and AIDS. According to KAIS 2007 report, different age groups have diverse
HIV and AIDS needs and challenges hence the need to formulate intervention strategies based on
the different age groups. Table 4 depicts that most of the respondents were in 16-18 age group at 62
percent followed by 13-15 at 24.2 percent and 19-22 at 3.5 percent. From table 4 age group 13-18
forms the majority of the respondents at 86.2 percent. A number of the Students at this age are in
between form 1 and form three. This is the age at which most sexual debuts occur and therefore a
need to put more emphasis on safe sex practices.

4.3 Education of Students about HIV/ AIDS and Prevention of the Disease
Education about HIV and AIDS in Rift Valley Technical Training Institute in Eldoret was
important since it was expected to influence their ability to identify and take various precautionary
measures to prevent the spread of HIV and AIDS. For instance, students are likely to avoid
contracting the disease if they have adequate Education on how it is transmitted. Similarly, students
are likely to use condoms if they are aware that it can help to prevent the spread of HIV/ AIDS.
Therefore, students were asked if they had ever heard about HIV and AIDS. All the students (371)
had heard about HIV and AIDS.

4.3.1 Education and Perceptions of Students on HIV and AIDS

The Education and perceptions of HIV and AIDS were measured by asking the respondents
whether they had ever heard of HIV and AIDS. The data from the survey revealed that 100 percent
had heard about the disease. This indicated that the level of HIV and AIDS awareness was very
high in Rift Valley Technical Training Institute in Eldoret and this therefore provides a major
opportunity for formulating diverse interventions on HIV response. Out of the 371 Student
respondents who participated in the study, 371 were aware of the existence of HIV and which
represented 100 percent. This finding is comparable to that of Murtala (2009) who found that 97.5%
of secondary students in Katsina, Nigeria had heard about HIV and AIDS. The finding means that
there is a general high awareness about HIV/ AIDS among institute going Students in Uasin Gishu
County . However, the finding does not reveal the quality of information or what the students know
about the disease, as well as, how they got the information.

4.3.2 Source of Information about HIV and AIDS for Rift Valley Rift Valley institute student
The Students were asked to state their sources of information about HIV and AIDS. Knowing the
main sources of information about the disease was important because it is likely to help health
policy makers, the community, and institutes to use the right communication channels to inform the
Students about HIV and AIDS. Table 2 shows that students obtained information about the disease
from multiple sources.

Table 2: Sources of information about HIV/AIDS by the Students

Source Frequency (n= 371) Percentage (%)
Institutes 251 67.7
Students clubs 237 63.9
Health centre 231 62.3
Mass media 229 61.7
IEC materials 190 51.2
Community health workers 188 50.7
Church/ Mosque 125 33.7
NGOs 73 19.7
Reproductive health motivators 27 7.3
PET group 24 6.5

Students clubs are important sources of information because they encourage open talk among peers
about HIV and AIDS. In this respect, Rift Valley Rift Valley institute students in Sub District are
likely to acquire adequate information about the disease if the discussions in their Students clubs are
led by experts or people who have accurate and enough information about HIV and AIDS. The
high utilization rate of health centres as a source of information about HIV is consistent with the
perspective of Obare et al (2010), who found that the Students in Kenya prefer to talk to health care
service providers and counselors about sexually transmitted disease and reproductive matters.
The finding also suggest that counseling services in health centres is highly accessible in Uasin
Gishu County since over 50% of the respondents could access information about HIV from them.
The high utilization rate (61.7%) of mass media as a source of information reflects increased access
to various media channels such as radio, televisions, newspapers, and mobile phones with FM radio
capabilities. In this respect, the Students are expected to access information about the disease
through mass media and IEC materials such as posters because the Ministry of Health often
carryout campaigns against HIV and AIDS through them (NASCOP, 2009).

4.3.3 Modes of HIV Transmission in Rift Valley Technical Training Institute in Eldoret
Modes of transmission are important indicators of measuring the level of awareness about HIV
infection. Table 6 contains data on the Education base of respondents in regards to modes of HIV
transmission. Students were asked to state the modes of HIV transmission that they were aware of
to test the quality and depth of Education they had about the disease. Students’ responses to this
question are presented in table 3.

Table 3: The Students’ Education on Modes of HIV transmission

Mode of transmission Frequency (n =371) Percentage (%)

Unprotected sex 337 90.8

Sharing sharp objects 323 87.1

Blood transfusion 303 81.7

Deep kissing 233 62.8

Wounds/ cuts 149 40.2

Sharing toothbrushes 126 34.0

MTC 112 30.2

Blood contact 85 22.9

Table 7 shows that at least 80% of the students were aware that unprotected sex and sharing sharp
objects could lead to transmission of HIV/ AIDS. This result is consistent with that of Murtala
(2009) who found that at least 80% of secondary students in Katsina, Nigeria knew that sexual
intercourse, use of needles/ syringes on human body, and blood transfusion are major means by
which HIV is transmitted.

The study also revealed that 81.1% of the students were aware that blood transfusion can lead to
HIV/ AIDS transmission. Moreover, 62.8% of the students knew that HIV/ AIDS can be acquired
through deep kissing. Only 40.2% of the respondents knew that they could acquire the disease by
coming into contact with the wounds of an infected person. These findings are supported by those
of Murtala (2009) who found that 86.7% of Rift Valley Rift Valley institute students in Katsina,
Nigeria were aware that HIV/ AIDS could be transmitted through blood transfusion. The research
also found that only 8% of the students in Nigeria knew that HIV/ AIDS could be transmitted
through kissing.

Table 7 shows that less than 35% of the students knew that sharing toothbrushes, MTC, and coming
into contact with blood of an infected person can lead to transmission of the disease. This means
that students lack perfect information about the modes of HIV/ AIDS transmission. Moreover, the
finding suggests that the students are at risk of being infected since ignorance of some modes of
transmission could lead to increased infection rates. This perspective is supported by the findings of
Hussein (2005) who concluded that institute and collage going Students in Garisa District were at
risk of contracting HIV because they were unaware of the risky sexual behaviors that could lead to
transmission of the disease.

4.3.4 Strategies of HIV Prevention in Rift Valley Technical Training Institute in Eldoret
HIV and AIDS prevention strategy is very important in the sense that it is possible to gauge
whether the Students know different ways of protecting themselves from contracting the HIV virus.

Students were asked to identify the various strategies for preventing HIV/ AIDS that they were
aware of. The responses to this question are summarized in table 8.
 Table 4 HIV prevention strategies adopted by the Students in Rift Valley Technical institute

Strategy Frequency (n =371) Percentage (%)

Abstinence 341 91.9
Condom use 330 88.9
Not sharing sharp objects 243 65.5
Faithfulness to one uninfected partner 221 56.9
VCT (Testing for HIV) 162 43.7
Counseling 132 35.6
Blood screening 72 19.4
Not sharing toothbrushes 72 19.4
PMTCT 49 13.2
Avoiding harmful cultural practices 34 9.2
Installing moral values 33 8.9
BCC 24 6.5
No response 11 3
Do not know 0 0

The main HIV/ AIDS prevention methods that the students knew included abstinence, using
condoms, not sharing sharp objects, and being faithful to one uninfected sexual partner. These
strategies or prevention methods were known by majority (at least 50%) of the students.

Less than 50% of the students were aware that knowing one’s HIV status and obtaining counseling
services from VCTs was a way of preventing the disease. Conceptually, students who are aware of
their HIV status are likely to take measures to avoid contracting or spreading the disease if they
obtain appropriate counseling and guidance services (Ndegwa, 2002). Less than 20% of the
students were aware that blood screening before transfusion, PMTCT, and avoiding sharing
toothbrushes could lead to transmission of the disease.

Table 8 shows that less than 10% of the students knew that refraining from harmful cultural
practices such as wife inheritance and female genital mutilation (FGM) are effective methods of

preventing HIV and AIDS infection. In addition, BCC and instilling moral values were considered
effective strategies for preventing the disease by less than 10% of the students.
There is a huge information asymmetry concerning the methods of HIV prevention among students
in Sub District. This suggests that poor Education about HIV prevention methods in Rift Valley
Technical Training Instittute in Eldoret could be one of the major causes of the high prevalence of
the disease in Sub District. Oyo-Ita et al (2005) also found that students in Calabar Nigeria had very
poor Education of HIV prevention methods. In their study, only 48% of the students were aware
that keeping one sexual partner, using condoms, blood screening, and abstinence could help to
prevent HIV/ AIDS. According to Uganda AIDS Commission (2012), the imperfect Education
about HIV prevention methods is explained by the fact that health care policy makers often over
emphasize the importance of the major prevention methods such as protected sex at the expense of
other equally important measures such as avoiding getting into contact with the blood of an infected
person. The Students tend to remember only the prevention methods that they regularly hear about
in institutes and the mass media.

4.3.5 Statements about HIV and AIDS

In addition to knowing about effective ways to avoid contracting HIV, it was also useful to be able
to identify incorrect beliefs about the disease to eliminate misconceptions. Common misconceptions
about AIDS include the idea that all HIV-infected people always appear ill and the belief that the
virus can be transmitted through sharing of clothes. The respondents were asked about these
misconceptions including different ways of protecting oneself and the findings are presented in
table 5.
 Table 5: Statements about HIV/ AIDS by the Students

Statement True False No Total

(%) (%) response (%)
(%)
An individual can protect him/herself from HIV 93.5 3.5 3.0 100.0
infection by abstinence
An individual can protect him/herself from HIV 85.7 11.1 3.2 100.0
infection by being faithful to one partner
Proper use of condom can protect one from HIV 87.9 8.6 3.5 100.0
Infection
An individual who looks healthy can also be also be 83.0 14.0 3.0 100.0
infected with HIV
Sharing of clothes can also transmit HIV 9.4 87.6 3.0 100.0
Sharing of sharp objects can also transmit HIV 90.0 0.5 9.4 100.0
Unprotected sex is the main mode of HIV infection 93.0 4.0 3.0 100.0
Some cultural beliefs and practices enhance HIV 66.3 30.2 3.5 100.0
Infection
There is a linkage between STI and HIV 84.1 11.9 4.0 100.0

Table 9 indicates that over 80% of the students knew that abstinence, being faithful to one partner
and proper use of condom could protect an individual from HIV infection. This finding is supported
by that of Pankaj et al. (2012) who found that at least 84% of secondary students in Pune, India
were aware that HIV infection could be avoided by engaging in safe sex practices such as
abstinence and using condom. According to Pankaj et al. (2012), students are likely to participate
effectively in HIV prevention if they know the major methods of transmission and prevention of the
disease.
The students were also aware of the various HIV/ AIDS modes of transmission. 90% of the students
knew that sharing sharp objects could lead to HIV transmission. Over 85% of the students were
aware of the fact that the disease cannot be easily transmitted through sharing clothes. At least 80%
of the students knew that a person who looks healthy could be infected with the disease.Ochieng et
al. (2011) also found that over 70% of Rift Valley Rift Valley institute students in Kisumu had
adequate Education of the main HIV prevention methods.
The study revealed that 93% of the students knew that unprotected sex is the main mode of HIV
transmission. 84.1% of the students also knew that there is a link between STI and HIV. This
Education is important because individuals with STIs are more susceptible to HIV infection than
those who are not suffering from any STI. However, only 66.3% of the students considered cultural
practices and beliefs such as wife inheritance as factors that enhance the spread of HIV/ AIDS.

Overall, table 9 confirms the earlier findings, which suggested that the Students lack accurate
Education about the disease. For instance, 30.2% of the students do not believe that risky cultural
practices such as FGM promote the spread of HIV/ AIDS. Similarly, 11.1% of the students believe
that being faithful to one sexual partner cannot prevent the spread of HIV and AIDS. This means
that the students can be tempted to have multiple sexual partners thereby enhancing instead of
preventing the spread of the disease.Ochieng (2005) in his study of reproductive and sexual health
behavior in Kisumu County also found that the Students had misconceptions on how HIV is
transmitted and prevented. One of the possible explanations to the inconsistency of the Education
that the Students have is misinterpretation of information coupled with believing in the myths
about the disease. Specifically, if students fail to understand what they are taught about HIV/ AIDS,
then they are likely to have misconceptions about it (Hussein, 2005).

4.3.6 Cultural Practices and the Spread of HIV and AIDS in Rift Valley Technical Training
Institute in Eldoret
The researcher also sought to establish whether the Students would clearly identify some of the
cultural practices that would enhance the spread of the HIV virus. This was important in the
designing of HIV programs for the Students. The results were as show in table 10.
 Table 6: The Students’s Education on cultural practices that enhance the spread of HIV/
AIDS

Cultural practice Frequency (n =371) Percentage (%)

Wife inheritance 162 43.7
Polygamy 100 27.0
Traditional male initiation 80 21.6
Sharing sharp objects 77 20.8
Blood sucking 56 15.1
Female circumcision (FGM) 53 14.3
Scarification 33 8.9
Removal of teeth 26 7.0

Table 10 shows that the students in Rift Valley Technical Institute in Uasin Gishu County have
very little Education of the cultural practices that enhance the spread of HIV despite the fact that
they reside in rural areas where cultural practices such as wife inheritance and polygamy are
common. The practices listed in table 9 have the potential of facilitating the spread of HIV/ AIDS.
However, none of them could be identified by at least 50% of the students as a risk factor. Wife
inheritance was identified by 43.7% of the students as a cultural practice that enhance HIV
infection. This means that it is the main practice, which students associate with HIV infection in the
district. Other major cultural practices that were identified by the students were polygamy, which
encourages sex with multiple partners, sharing sharp objects, and traditional male initiation that
can cause HIV infection through sharing of equipment such as circumcision knives.

Blood sucking, FGM, sacrificing, and removal of teeth were identified by less than 20% of the
students as cultural practices that could lead to HIV/ AIDS infection. This suggests that the students
consider the aforementioned practices as minor modes of HIV transmission. One of the possible
explanations of this finding is that most of the cultural practices listed in table 9 might notbe
widespread in Uasin Gishu County . Thus, the Students have little Education about them, including
how they can lead to HIV infection. According to Mbozi(2008), the students are less likely to
associate cultural practices such as polygamy and wife inheritance with the spread of HIV and
AIDS if they hold these practices in high esteem by considering them as an integral part of their
culture.
4.4 Attitudes of the Students and their Participation in HIV Prevention on peer education
Stigma and discrimination in a population can adversely affect both people’s willingness to be
tested and their adherence to antiretroviral therapy. Reduction of stigma and discrimination in Rift
Valley Technical Training Institute in Eldoret is, thus, an important indicator of the success of
programmes targeting HIV and AIDS prevention and control.

4.4.1 Maintaining Secrecy about Family Member Infected with HIV

In the event that a family member was infected with HIV/ AIDS, students were asked if they
wanted the information to remain secrete or not. The students responded to this question as shown
in table 7.

Table 7: Level of secrecy by the Students about a family member’s infection with HIV

Response Frequency Percentage (%)

Strongly agree 166 44.7
Agree 128 34.5
Neutral 51 13.8
Disagree 14 3.8
Strongly disagree 12 3.2
No response 0 0
Total 371 100

Table 11 shows that 44.7% of the students strongly agreed that the information about the positive
HIV status of a member of their family should remain secret. Moreover, 34.5% agreed that the
information should remain secret. 13.8% of the students were neutral, which means that they
neither agreed nor disagreed that the information should be shared. The finding indicates that
stigma against HIV/ AIDS patients is still a problem in Uasin Gishu County . Cameron (2010) in
his study of the responses adopted to reduce HIV noted that stigma against HIV/AIDS patients is
still a problem both indeveloped countries such as Brazil and developing countries such as
Zimbabwe,

Zambia, and Botswana. Attawell, Pulertwitz, and Brown (2002) contend that stigma against HIV
patients arises from the fear of contagion and the disease itself. These fears are exacerbated by
shame, guilt, and low self-esteem.
Only 3.8% of the students disagreed that the information about the HIV positive status of a member
of their family should remain a secret. Similarly, 3.2% of the students strongly disagreed. Students
in Uasin Gishu County are likely to avoid sharing information about the HIV status of their family
members to avoid shame or embarrassment. According to Cameron (2010), stigma is a negative
attitude that worsens the conditions of HIV patients. Stigma can lead to job loss, institute expulsion,
violence, and denial of health services among HIV patients. It also enhance the spread of the
disease because people living in fear are less likely to adopt preventive behavior, go for testing, and
access care and adhere to treatment.

4.4.2 Sharing a Desk with an Infected Classmate

Students were asked if they would agree to share a desk with a classmate who has been infected
with HIV. Table 12 presents the students responses to this question.

Table 8: Ability of the Students sharing a desk with an infected classmate

Response Frequency Percentage (%)
Strongly agree 191 51.4
Agree 57 15.4
Neutral 11 3.0
Disagree 59 15.9
Strongly disagree 42 11.3
No response 11 3.0
Total 371 100

Table 12 shows that majority of the students (51.4%) strongly agreed to share a desk with an
infected classmate. Another 15.4% agreed to share their desks with an infected classmate. 3% of the
students were neutral, which means that they could not take a stance on whether to or not to share a

desk with an infected classmate. The finding means that discrimination against HIV patients in the
institute setting is not a major problem in rural Rift Valley Technical Institute in Uasin Gishu
County . According to NCHSR (2012), health care providers and the community can only provide
care and support to HIV patients if they have a positive attitude towards them. This implies that
students in Uasin Gishu County are likely to provide emotional support to their infected colleagues
or to encourage them to seek medication.
Table 12 also shows that 15.9% of the students disagreed to share a desk with an infected
classmate. Another 11.3% strongly disagreed. The implication of this finding is that the students
who have a negative attitude towards their colleagues who are HIV positive are likely to practice
discrimination and stigmatization. This would limit their ability to participate in the prevention of
HIV/ AIDS.

4.4.3 Encounter with STIs in Rift Valley Technical Training Institute in Eldoret
The respondents were asked if they had encountered an STI to understand the implications of their
sexual activities. The study found that nearly 82% of the students had not been infected by a
sexually transmitted infection (STI). Only 6.7% had been infected by an STI, whereas 11.1% did
not indicate whether they had been infected or not. The result suggests that the prevalence of STIs
among Rift Valley Rift Valley institute students is low.
 CHAPTER FIVE
SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS

5.1 Introduction
This chapter will present a summary of the major findings of the study. The conclusions of the
study will also be presented in this chapter. In addition, recommendations for improving the
participation of peer education in Rift Valley Rift Valley institute students in prevention of HIV
will be made. The chapter will also highlight the study’s contribution to the body of Education and
the areas for further research.

5.2 Summary of Findings

The study revealed that 66.6% of the students had encountered a social condition that exposed them
to the risk of acquiring HIV. 53.8% of the students stated that having unprotected sex was the main
adverse social condition that exposed them to the risk of acquiring HIV. In addition, 29.1% of the
students were likely to acquire HIV because of lack of post exposure prophylaxis. Risky leisure
activities such as drinking alcohol and smoking had been encountered by 27.1% of the students.
However, poverty and peer pressure were considered adverse social conditions by only 10.5% and
15.4% of the students respectively.

5.3 Conclusions
The study shows that there is high awareness about HIV/ AIDs in general. However, the quality of
peer education that students have about the disease is not perfect. Majority of the students have
basic Education about the major modes of HIV transmission, as well as, the main methods of
preventing the disease. However, majority of the students have inadequate Education about the
cultural practices that can lead to HIV infection. In addition, they lack Education of important
measures for preventing HIV/ AIDS such as blood screening before transfusion. In this respect, the
quality of Education that students have is not adequate to enable them to participate effectively in
prevention of HIV/ AIDS.

The students have a positive attitude towards their colleagues and members of the society who are
infected with HIV and AIDS. Moreover, majority of them believe that the use of condom should be
taught in institutes. Majority of the students are not willing to share information about their relatives
who are HIV positive. This implies that fear, stigma, and discrimination against HIV patients in the
community are barriers that prevent students from participating in prevention of HIV/ AIDS.
The study shows that majority of the students are sexually active and most of them are using
condoms. However, the main reason for using condoms was to prevent unwanted pregnancies
rather than HIV/ STIs. Therefore, the students are at risk of being infected with HIV since they are
likely to abandon using condoms if they find alternative contraceptives. The prevalence of STIs
including HIV among the students is low. However, STIs are still a threat to students’ participation
in prevention of HIV because they increase the likelihood of acquiring the disease and most of
those who are already infected hardly seek medical treatment. Although the uptake of HIV test is
high, stigma and the fear of knowing one’s status still prevent some students from going for the
tests as a way of participating in the prevention of HIV/ AIDS.

Adverse social conditions also prevent Rift Valley Rift Valley institute students from
participating in the prevention of HIV/ AIDS. The social conditions that expose the students to the
risk of acquiring the disease include having unprotected sex, lack of access to treatment after
potential exposure to HIV, and having unprotected sex.

5.4 Recommendations
The following policy recommendations should be considered by the institute administrators and the
government to enhance prevention of HIV/AIDS among institute going Students. First, the study
revealed that students did not have perfect or accurate information or Education about HIV/ AIDS.
This problem should be solved by improving the quality of information about HIV and AIDS. This
should involve consolidating accurate information about the disease and disseminating it through
appropriate means such as formal class lessons, Students clubs, and health centers. This will help in
eliminating the myths and use of incorrect information that is likely to expose students to higher
risk of infection.

Second, the study found that risky sexual behavior such as having unprotected sex is a problem that
limits students’ participation in prevention of HIV/ AIDS. In order to solve this problem, institute
administrators, parents, and the government should promote responsible behaviors among students.
Since majority of the students are already sexually active, the use of condoms should be promoted.
In this respect, the use of condoms should be encouraged as a means of preventing HIV/AIDS
rather than just avoiding unwanted pregnancies. Additionally, abstinence should be promoted in
Rift Valley Technical Training Institute in Eldoret .
5.7 Areas for Further Research
This study focused only on the Education and attitudes of institute Students, as well as, their
sexual behavior and social conditions. Thus, in future the following areas should be considered for
further researcher. To begin with, future studies can use a larger sample size by including the
Students who are not in institute in Sub District. Future studies can also explore how variables such
as mental health, social norms, social networks, and sexual abuse influence the participation of the
Students in prevention of HIV/ AIDS.
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 APPENDICES

QUESTIONNAIRE
I was a student at the Rift Valley Technical Training Institute, Department of Sociology and Social Work
conducting a research Peer Education in HIV/AIDS prevention in Rift Valley Technical Training
Institute in Eldoret

Your responses will be treated with almost confidentiality and will only be used for education purposes.

Kindly put a tick (/) where appropriate.

SECTION ONE: DEMOGRAPHICS

1. How old are you (in years)?

( ) 15-16yrs ( ) 19-20yrs ( ) 23-24yrs
( ) 17-18yrs ( ) 21-22yrs
2. What is your gender
a. Male ( ) b. Female ( )
3. What is the name of your institute or Institution?
4. What is your level of education?
a. Form 2 ( )
b. Form 3 ( )
c. Form 4 ( )
d. College ( ). Specify what level
5. What is your Religion/ denomination
a. Christian ( )
b. Muslim ()
c. Other (specify) ( )
SECTION 2: EDUCATION RELATED TO HIV/AIDS

6. a) Are you aware of HIV/AIDS

a. Yes ( ) b. No ()
7. a) Have you ever received information on HIV/AIDS?
a. Yes ( ) b. No ( )
b) If you have received information on HIV/AIDS, how much information about HIV/AIDS do you
gain from following sources?
a. Television No ( ) Little ( ) Some ( ) A lot ( )
b. Radio No ( ) Little ( ) Some ( ) A lot ( )
c. Newspapers No ( ) Little ( ) Some ( ) A lot ( )
d. Pamphlet/Poster No ( ) Little ( ) Some ( ) A lot ( )
e. Health care workers No ( ) Little ( ) Some ( ) A lot ( )
f. Campaigns No ( ) Little ( ) Some ( ) A lot ( )
g. Religious Leaders No ( ) Little ( ) Some ( ) A lot ( )
h. Friend No ( ) Little ( ) Some ( ) A lot ( )
i. Sexual Partner No ( ) Little ( ) Some ( ) A lot ( )
j. In class at institute No ( ) Little ( ) Some ( ) A lot ( )
k. Institute health education No ( ) Little ( ) Some ( ) A lot ( )
l. Peers No ( ) Little ( ) Some ( ) A lot ( )
m. Family member No ( ) Little ( ) Some ( ) A lot ( )
n. Internet No ( ) Little ( ) Some ( ) A lot ( )

c) If others (specify)
8. Is HIV a Bacterium?
a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )
9. Is HIV a Virus?
a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )
10. Does HIV cause AIDS?
a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )

11. Is HIV/AIDS a growing problem in this community?

a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )
12. Is AIDS a fatal disease?
a. Yes ( ) b. No ( ) c. Don’t Know ( )
13. a) Is there a cure for AIDS?
a. Yes ( ) b. No ( ) c. Don’t Know ( )

b) Explain your answer

14. A person can be infected with HIV and not have the disease AIDS
a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )
15. Can a healthy looking person have HIV/AIDS?
a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )
16. a) To what extent do you feel the following practices transmit HIV/AIDS? (where 4 is Strongly
agree, 3 is Agree, 2 is neutral, 1 Disagree and 0 Strongly Disagree )
4 3 2 1 0
HIV/AIDS TRANSMISSION

Sexual intercourse
Contact with blood of infected person
Casual contact with infected person ( i.e. sharing food, cup, glass,
handshake, hugging, clothes)
Not using condoms
Contact with infected person's toothbrush/shaving material
During Pregnancy
During Birth
Through Breast Milk
Blood transfusion
Sharing Needles (drug use), razor blades
Unclean Medical Equipment
Kissing
Mosquito/Insect bites

b) If others (specify)
17. Which are the symptoms of HIV/AIDS? Kindly tick the relevant ones.
a. Fever ()
b. Diarrhoea ()
c. Nausea and Vomiting ()
 d. Weight loss ()
e. persistent skin rashes ()
f. Fatigue ()
g. Others (Specify)
18. Can a person do anything to protect him/herself from getting HIV/AIDS?
a. Yes ( ) b. No ( ) c. Don’t Know/Don’t Remember ( )
19. How can people protect themselves from getting infected with HIV/AIDS?
a. Abstain from sex ()
b. Non penetrative sex/thigh sex ( )
c. Always use condoms ()
d. Limit number of sex partners ()
e. Have only one sex partner ()
f. Avoid sex workers ()
g. Have sex with a virgin ( )
h. Use sterilized needles ()
i. Require partner to take blood test( )
j. Other (specify)
k. don’t know/don’t remember ()
20. a) Have you ever heard of diseases other than HIV/AIDS that can be transmitted through sexual
intercourse?
a. Yes ( ) b. No ( )

b) If yes, specify

21. In your opinion, who are the people likely to be infected with HIV/AIDS?
a. Parents ()
b. Students ()
c. Prostitutes ()
d. Others (Specify)

22. In your own opinion, what is the probability that you may get infected with HIV/AIDS?
a. Very high ()
b. High ()
c. Neutral ()
 d. Low ()
e. Very low ()
23. Do you know anyone infected with HIV/AIDS?
a. Yes ( ) b. No ( )

SECTION 3: PEER EDUCATION OF STUDENTSS TOWARDS HIV/AIDS

24. Most Students who have HIV/AIDS have only themselves to blame
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ()
25. Most Students who have HIV/AIDS deserve what they get
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
26. Students should be removed from the institute if they are HIV positive
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
27. I feel more sympathetic towards students who get HIV/AIDS from blood transfusion than those
who get it from drug abuse
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
28. I have little sympathy for students who get HIV/AIDS from sexual promiscuity
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
29. Students with AIDS should be treated with the same respect as other students
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
30. I am worried about getting HIV/AIDS from social contact with a fellow students in institute
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
31. People with HIV/AIDS should tell their sexual partners that they are infected
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
32. I am sympathetic towards the misery that students with HIV/AIDS experience
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
33. I would like to do something to make life easier for people with HIV/AIDS
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
34. I am comfortable discussing with someone HIV/AIDS
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
35. I have heard enough about HIV/AIDS and I don’t want to hear about it anymore.
a. Strongly Agree ( ) b. Agree ( ) c. Neutral ( ) d. Disagree ( ) e. Strongly Disagree ( )
36. What would you do if you found out that a friend of yours was infected with HIV/AIDS? Please
tick only one response.
a. Offer them support and sympathy ()
 b. Offer them support but consider that they deserve it for some reason ()
c. Continue to be friends but avoid physical contact ()
d. Avoid them ()

SECTION 4: PREVENTIVE PRACTICES AFTER EDUCATION ON HIV/AIDS

37. Have you ever used a condom?

a. Yes ( ) b. No ( )
38. Did you use a condom the last time you had sex?
a. Yes ( ) b. No ( )
39. Would you use condoms if you get them for free?
a. Yes ( ) b. No ( )
40. In the past year have you: please tick one response.
a. Had sexual relations only with a regular partner ()
b. Had sexual relations with more than one partner ()
c. Had no sexual relation ()
41. Have you ever had an HIV test?
a. Yes ( ) b. No ( )
42. Would you like to have an HIV test?
a. Yes ( ) b. No ( )
43. Do you know where you can have an HIV test in your community?

a. Yes ( ) b. No ( )

44. a) Have you changed your sexual behavior habits because of information gained from HIV/AIDS
awareness campaigns or programs
a. Yes ( ) b. No ( ) c. Somewhat ( )
b) Please explain your answer
45. Has the topic HIV/AIDS been included in your study program?
d. Not at all ( ) b. Somewhat ( ) c. Sufficiently ( )
46. How do you asses your theoretical Education in HIV/AIDS to be
e. Poor () b. Fair ( ) c. Good ( ) d. Very Good ( )
47. Do you think that the Students should have an informative role concerning HIV/AIDS to the public?
a. Yes ( ) b. No ( )
48. Who is most suitable to give information about HIV/AIDS?
f. Doctor ()
 g. Teacher ()
h. Parents ()
i. Fellow students ()
j. Others (Specify)
49. a) More HIV/AIDS programs and training in institutes and institutes are necessary.
a. Yes ( ) b. No ( )
b) Explain your answer

50. What do you think would make the HIV/AIDS awareness programs more effective for young
people?

Thank you very much for your time and cooperation.